The epithelial interface with osseointegrated implants.

The development of osseointegration has generated interest in the field of intraoral and maxillofacial implantology. There is well documented evidence of a high level of success in achieving osseointegration, using titanium and alumina-ceramic implant materials. Long term retention of intraoral implants appears in part, to be dependent upon the integrity of the epithelium/implant interface. This paper presents the design features of two commercially available systems Intra-Mobile-Zylinder (IMZ) and Tubingen (Frialit), which represent titanium and alumina-ceramic implants respectively, and reviews current knowledge of the nature of the epithelial junction to implant materials and the bacterial flora associated with successful and failing implants. Implant failure may be caused by a site specific infection with a similar ecosystem and bacterial flora to that found in periodontal disease. Care in patient selection and maintenance of a healthy epithelial junction are essential for the long term function of osseointegrated implants.